成人中心性肥胖的腰围切点分析  

Cut-off values of waist circumference for central obesity in Chinese adults

作　　者：温潇潇[1] 麦劲壮[2] 高向民[2] 郭敏[1] 吴勇[2] 刘小清[2] 赵连成[1] 

机构地区：[1]中国医学科学院北京协和医学院阜外心血管病医院社区防治部,100037 [2] 广东省心血管病研究所广东省人民医院广东省医学科学院流行病学研究室

出　　处：《中华心血管病杂志》2015年第9期822-826,共5页Chinese Journal of Cardiology

基　　金：“八五”国家科技攻关计划（85-915-01-01）

摘　　要：目的 探讨我国成人中心性肥胖和严重中心性肥胖的腰围切点值.方法 利用中美心肺血管病流行病学合作研究1993至1994年的横断面调查资料,纳入其中年龄在35～69岁且资料完整者的10 265名作为研究对象.以腰围的每个整数厘米值为切点,计算各切点检出危险因素聚集（同一个体同时具有2个及以上主要心血管病危险因素）的敏感度、特异度及受试者工作特征（ROC）曲线距左上顶点的距离,以距离最短的腰围切点值作为诊断中心性肥胖的腰围切点,以特异度≥90％的腰围切点值作为诊断严重中心性肥胖的腰围切点.结果 男性腰围为（80.5＆#177;9.9）cm,女性腰围为（77.8＆#177;10.0）cm.男女性危险因素聚集率分别为18.1％（890/4 921）和14.5％ （776/5 344）.当男性腰围≥84 cm、女性腰围≥80 cm时,对应的ROC曲线距左上顶点距离最短,分别为0.430和0.450;当男性腰围≥93 cm、女性腰围≥91 cm时,预测危险因素聚集的特异度≥90％.结论 本研究的成人中心性肥胖和严重中心性肥胖的腰围切点值与中国成人超重和肥胖症预防与控制指南推荐的切点值相同或相近.Objective To investigate the appropriate cut-off values of waist circumference（WC）for central obesity and severe central obesity in Chinese adults.Methods A total of 10 265 participants aged 35-69 years from the cross-sectional survey of the PRC-USA Collaborative Study of Cardiovascular and Cardiopulmonary Epidemiology between 1993 and 1994 with integral data were included.Each integer unit in centimeters of WC in a given range was used as the cut-off point to detect clustering of risk factors,which was defined as an individual with 2 or more risk factors including hypertension,diabetes,hypercholesterolemia,hypertriglyceridemia and low levels of high-density lipoprotein cholesterol.Sensitivity,specificity and distance from the receiver operating characteristic （ROC） curves to the upper left corner of the ROC graph were calculated.The WC value corresponding to the point on the ROC curve nearest to the upper left corner was considered as the optimal cut-off value for central obesity and the value corresponding to the point with specificity of 90% or more was considered as the optimal cut-off for severe central obesity.Results The mean WC was （80.5 ＆#177; 9.9） cm in men and （77.8 ＆#177; 10.0） cm in women;18.1% （890/4 921） of men and 14.5% （776/5 344） of women were identified with two or more major risk factors.Based on the ROC curve analysis,the optimal value of WC to detect clustering of risk factors was ≥ 84 cm for men and ≥80 cm for women,and the shortest distance to the upper left comer was 0.430 and 0.450,respectively.The cut-off values of WC to detect clustering of risk factors with specificity of 90% or more were ≥93 cm and ≥91 cm for men and women,respectively.Conclusion The cut-off points of WC for central obesity and severe central obesity in Chinese adults obtained from this study are equal or similar to the WC cut-off values proposed by the Guidelines for Prevention and Control of Overweight and Obesity in Chinese Adults.

关 键 词：肥胖症 危险因素 

分 类 号：R589.2[医药卫生—内分泌]